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Intravitreal Steroids pp 69–79Cite as

Intravitreal Steroids for the Treatment of Macular Edema in Retinal Vein Occlusions

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Abstract

Retinal vein occlusion is considered a multifactorial disease with a complex pathogenesis that often reflects locally systemic vascular and hemodynamic disorders. Put in motion by retinal ischemia and subsequent macular edema, macrophages, neutrophils, and microglia participate in the concert of inflammatory responses, in which, among others, several inflammatory mediators such as prostaglandins, IL-1, TNF-alpha, VEGF, and ICAM-1 are involved. Intravitreal triamcinolone injections, the dexamethasone implant, as well as fluocinolone acetonide inserts are currently available for the treatment of macular edema secondary to central or branch retinal vein occlusions. Overall, steroids in RVO offer effective monotherapy and are indeed capable of upgrading other treatment modalities by inducing a comprehensive and long-standing anti-inflammatory and antiangiogenic effect. Additionally sustained-release formulations allow reduction of burden of intravitreal anti-VEGF injections. Intravitreal steroids are also an alternative option for patients not responding to regular anti-VEGF treatments, and there is some evidence that their combination with laser in BRVO may be synergistic.

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References

  1. Capone Jr A, Singer MA, Dodwell DG, Dreyer RF, Oh KT, Roth DB, Walt JG, Scott LC, Hollander DA. Efficacy and safety of two or more dexamethasone intravitreal implant injections for treatment of macular edema related to retinal vein occlusion (Shasta study). Retina. 2014;34(2):342–51.

    Article  CAS  PubMed  Google Scholar 

  2. Coscas G, Loewenstein A, Augustin A, Bandello F, Battaglia Parodi M, Lanzetta P, Monés J, de Smet M, Soubrane G, Staurenghi G. Management of retinal vein occlusion–consensus document. Ophthalmologica. 2011;226(1):4–28.

    Article  PubMed  Google Scholar 

  3. Fan C, Wang Y, Ji Q, Zhao B, Xie J. Comparison of clinical efficacy of intravitreal ranibizumab with and without triamcinolone acetonide in macular edema secondary to central retinal vein occlusion. Curr Eye Res. 2014;39:938–43.

    Article  CAS  PubMed  Google Scholar 

  4. Ford JA, Clar C, Lois N, Barton S, Thomas S, Court R, Shyangdan D, Waugh N. Treatments for macular oedema following central retinal vein occlusion: systematic review. BMJ Open. 2014;4(2):e004120. doi:10.1136/bmjopen-2013-004120.

    Article  PubMed Central  PubMed  Google Scholar 

  5. Gado AS, Macky TA. Dexamethasone intravitreous implant versus bevacizumab for central retinal vein occlusion-related macular oedema: a prospective randomized comparison. Clin Experiment Ophthalmol. 2014. doi:10.1111/ceo.12311. [Epub ahead of print] PubMed PMID: 24612095.

    Google Scholar 

  6. Glacet-Bernard A, Coscas G, Zourdani A, Soubrane G, Souied EH. Steroids and macular edema from retinal vein occlusion. Eur J Ophthalmol. 2011;21 Suppl 6:S37–44.

    Article  PubMed  Google Scholar 

  7. Glanville J, Patterson J, McCool R, Ferreira A, Gairy K, Pearce I. Efficacy and safety of widely used treatments for macular oedema secondary to retinal vein occlusion: a systematic review. BMC Ophthalmol. 2014;21:14–7.

    Google Scholar 

  8. Haller JA, Bandello F, Belfort Jr R, Blumenkranz MS, Gillies M, Heier J, Loewenstein A, Yoon YH, Jiao J, Li XY, Whitcup SM, Ozurdex GENEVA Study Group, Li J. Dexamethasone intravitreal implant in patients with macular edema related to branch or central retinal vein occlusion twelve-month study results. Ophthalmology. 2011;118(12):2453–60.

    Article  PubMed  Google Scholar 

  9. Haller JA, Bandello F, Belfort Jr R, Blumenkranz MS, Gillies M, Heier J, Loewenstein A, Yoon YH, Jacques ML, Jiao J, Li XY, Whitcup SM, OZURDEX GENEVA Study Group. Randomized, sham-controlled trial of dexamethasone intravitreal implant in patients with macular edema due to retinal vein occlusion. Ophthalmology. 2010;117(6):1134–46.e3.

    Article  PubMed  Google Scholar 

  10. Ip MS, Scott IU, VanVeldhuisen PC, Oden NL, Blodi BA, Fisher M, Singerman LJ, Tolentino M, Chan CK, Gonzalez VH, SCORE Study Research Group. A randomized trial comparing the efficacy and safety of intravitreal triamcinolone with observation to treat vision loss associated with macular edema secondary to central retinal vein occlusion: the Standard Care vs Corticosteroid for Retinal Vein Occlusion (SCORE) study report 5. Arch Ophthalmol. 2009;127(9):1101–14.

    Article  PubMed Central  PubMed  Google Scholar 

  11. Jaulim A, Ahmed B, Khanam T, Chatziralli IP. Branch retinal vein occlusion: epidemiology, pathogenesis, risk factors, clinical features, diagnosis, and complications. An update of the literature. Retina. 2013;33:901–10.

    Article  PubMed  Google Scholar 

  12. Joshi L, Yaganti S, Gemenetzi M, Lightman S, Lindfield D, Liolios V, Menezo V, Shao E, Taylor SR. Dexamethasone implants in retinal vein occlusion: 12-month clinical effectiveness using repeat injections as-needed. Br J Ophthalmol. 2013;97(8):1040–4.

    Article  PubMed  Google Scholar 

  13. Kuppermann BD, Haller JA, Bandello F, Loewenstein A, Jiao J, Li XY, Whitcup SM. Onset and duration of visual acuity improvement after dexamethasone intravitreal implant in eyes with macular edema due to retinal vein occlusion. Retina. 2014;34:1743–9.

    Article  CAS  PubMed  Google Scholar 

  14. Martin DF, Maguire MG, Fine SL, Ying G, Jaffe GJ, et al. Ranibizumab and bevacizumab for treatment of neovascular age-related macular degeneration: two-year results. Ophthalmology. 2012;119(7):1388–98.

    Article  PubMed Central  PubMed  Google Scholar 

  15. Moisseiev E, Goldstein M, Waisbourd M, Barak A, Loewenstein A. Long-term evaluation of patients treated with dexamethasone intravitreal implant for macular edema due to retinal vein occlusion. Eye (Lond). 2013;27(1):65–71.

    Article  CAS  Google Scholar 

  16. Noma H, Funatsu H, Harino S, Mimura T, Eguchi S, Hori S. Vitreous inflammatory factors in macular edema with central retinal vein occlusion. Jpn J Ophthalmol. 2011;55(3):248–55.

    Article  CAS  PubMed  Google Scholar 

  17. Peyman GA, Lad EM, Moshfeghi DM. Intravitreal injection of therapeutic agents. Retina. 2009;29(7):875–912.

    Article  PubMed  Google Scholar 

  18. Pichi F, Specchia C, Vitale L, Lembo A, Morara M, Veronese C, Ciardella AP, Nucci P. Combination therapy with dexamethasone intravitreal implant and macular grid laser in patients with branch retinal vein occlusion. Am J Ophthalmol. 2014;157(3):607–15.e1.

    Article  CAS  PubMed  Google Scholar 

  19. Pielen A, Feltgen N, Isserstedt C, Callizo J, Junker B, Schmucker C. Efficacy and safety of intravitreal therapy in macular edema due to branch and central retinal vein occlusion: a systematic review. PLoS One. 2013;8(10):e78538.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  20. Scholl S, Augustin A, Loewenstein A, Rizzo S, Kupperman B. General pathophysiology of macular edema. Eur J Ophthalmol. 2011;21 Suppl 6:S10–9.

    Article  PubMed  Google Scholar 

  21. Scott IU, Ip MS, VanVeldhuisen PC, Oden NL, Blodi BA, Fisher M, Chan CK, Gonzalez VH, Singerman LJ, Tolentino M, SCORE Study Research Group. A randomized trial comparing the efficacy and safety of intravitreal triamcinolone with standard care to treat vision loss associated with macular edema secondary to branch retinal vein occlusion: the Standard Care vs Corticosteroid for Retinal Vein Occlusion (SCORE) study report 6. Arch Ophthalmol. 2009;127(9):1115–28.

    Article  PubMed Central  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Ophthalmology, Sackler Faculty of Medicine, Tel Aviv Medical Center, Tel Aviv University, 6 Weizmann St, Tel Aviv, 64239, Israel

    Eran Zunz MD & Anat Loewenstein MD

Authors
  1. Eran Zunz MD
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  2. Anat Loewenstein MD
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Correspondence to Anat Loewenstein MD .

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Editors and Affiliations

  1. Städt. Klinikum Karlsruhe, Augenklinik, Karlsruhe, Germany

    Albert J. Augustin

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© 2015 Springer International Publishing Switzerland

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Zunz, E., Loewenstein, A. (2015). Intravitreal Steroids for the Treatment of Macular Edema in Retinal Vein Occlusions. In: Augustin, A. (eds) Intravitreal Steroids. Springer, Cham. https://doi.org/10.1007/978-3-319-14487-0_6

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  • DOI: https://doi.org/10.1007/978-3-319-14487-0_6

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-14486-3

  • Online ISBN: 978-3-319-14487-0

  • eBook Packages: MedicineMedicine (R0)

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